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NO.1 Three weeks following discharge, a male client is readmitted to the psychiatric unit for
depression. His wife stated that he had threatened to kill himself with a handgun. As the nurse
admits him to the unit, he says, "I wish I were dead because I am worthless to everyone; I guess I am
just no good." Which response by the nurse is most appropriate at this time?
A. "You've been feeling sad and alone for some time now?"
B. "Don't you think this is a sign of your illness?"
C. "I know with your wife and new baby that you do have a lot to live for."
D. "I don't think you are worthless. I'm glad to see you, and we will help you."
Answer: A
Explanation:
(A)
This response does not acknowledge the client's feelings.
(B)
This is a closed question and does not encourage communication.
(C)
This response negates the client's feelings and does not require a response from the client. (D) This
acknowledges the client's implied thoughts and feelings and encourages a response.

NO.2 In acute episodes of mania, lithium is effective in 1-2 weeks, but it may take up to 4 weeks, or
even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during
the first few days or weeks of an acute episode to manage severe behavioral excitement and acute
psychotic symptoms. In addition to the lithium, which one of the following medications might the
physician prescribe?
A. Sertraline (Zoloft)
B. Haloperidol (Haldol)
C. Alprazolam (Xanax)
D. Diazepam (Valium)
Answer: B

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Explanation:
(A) Diazepam is an antianxiety medication and is not designed to reduce psychotic symptoms. (B)
Haloperidol is an antipsychotic medication and may be used until the lithium takes effect. (C)
Sertraline is an antidepressant and is used primarily to reduce symptoms of depression. (D)
Alprazolam is an antianxiety medication and is not designed to reduce psychotic symptoms.

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